CRT Workshop

1.

5 points

The common complications of CRT implantation include (select all that apply)

Infection

Lead dislodgement

Cardiac tamponade

CAVB due to traumatic RBBB

2.

5 points

The most related complication to long procedural time of CRT implantation should be

Pneumothorax

Cardiac tamponade

LV lead dislodgement

Radiation burn

3.

5 points

According to 2015 ESC Guidelines, what is the class of indication for a patient with LVEF 32%, LBBB pattern, QRS width 125ms and NYHA level III?

I

IIa

IIb

III

4.

5 points

The limitation(s) of SJM QuickOpt includes (select all that apply)

Modulate AV delay only

Lower response rate in Afib and CAVB patients

The tests need to be conducted in supine postion

In-office operation only

5.

5 points

Which LV vector will best preserve battery longevity?
A. LV tip to LV ring: threshold 1.0V@0.4ms, impedance 354ohms
B. LV tip to RV ring: threshold 1.25V@0.4ms, impedance 893ohms
C. LV tip to Can: threshold 3.5V@0.4ms, impedance 346ohms

A

B

C

No difference among the vectors

6.

5 points

Which condition below would suggest the patient might present better CRT response?

LV intraventricular dyssynchrony > 65ms

Septal to posterior wall strain delay > 150ms

Interventrivular mechanical delay > 40ms

All of the above

7.

5 points

RA lead is unnecessary to AF patients during CRT implantation.

True

False

8.

5 points

For venous branch subselection, the use of the inner sheath can offer better support.

True

False

9.

5 points

While we assess the CRT setting using echo, what should we do when a patient presents E-A wave fusion in mitral VTI (velocity-time integral)?

Prolong A-V delay

Maintain current setting

Select RV ahead for V-V delay setting

Shorten A-V delay

10.

5 points

Which type of LV lead should we choose when the coronary branch is wide and less tortuous?

M shape

S shape

Double canted

Straight

11.

5 points

AdaptivCRT algorithm would choose LV pacing only when the patient presents (select all that apply)

sinus rhythm

SAV < 200ms

PAV > 250ms

heart rate <100bpm

12.

5 points

During CRT implant, one should follow the consensus below except

Same venous access for all leads

LV lead positioned at lateral wall or latest conduction site

Operation under multiple fluoroscopic views

RV lead implant first for back-up pacing

13.

5 points

The preprocedural assessment of CRT implantation should include (select all that apply)

Heart failure functional level (eg. NYHA, etc.)

Chest X-ray

Anti-platelet medication

Cardiac MRI

14.

5 points

What could be the factor(s) compromising CRT efficacy?

Suboptimized medication

Low patient compliance

Suboptimal device setting

All of the above

15.

5 points

During device interrogation, which of the following statement might indicate worsening heart failure?

Higher patent activity level

OptiVol alert

Higher heart rate variability

Difference between day and night heart rates

16.

5 points

According to 2012 ACC/AHA/HRS CRT guidelines, a Class I indicated patient should fit all the statements below except

NYHA III

LBBB

QRS width 135ms

LVEF 28%

17.

5 points

What factor(s) might decrease device longevity? (Select all that apply)

Increase lower rate

Increase pacing output

Turn on pre-arrhythmia EGM recording

Turn on Adaptiv BiV and LV

18.

5 points

If the CRTD device alert was triggered by lead integrity counter (short V-V interval counter), what could be the possible cause(s)? (Select all that apply)

EMI

High LV threshold

Loose set screw

Lead dislodgement

19.

5 points

When diaphragmatic stimulation occurs to a patient implanted with CRT, what should we do first?

Reposition LV lead

Measure LV threshold and PNS threshold

Reprogram LV vector

Remove LV lead and reimplant epicardial LV lead

20.

5 points

Suboptimal AV delay setting and BiV pacing less than 100% are the most likely device-related reasons for majority of CRT non-responders.

True

False